38 THE JOURNAL OF BONE AND JOINT SURGERY PROBLEMS ENCOUNTERED IN THE EARLY DIAGNOSIS AND MANAGEMENT OF CONGENITAL DISLOCATION OF THE HIP

This paper reports the results ofscreening 53 033 infants for congenital dislocation ofthe hip between 1970 and 1979, and compares them with the results of a similar screening programme between 1960 to 1969. The number of dislocations missed at neonatal examination is unaltered at 0.11 per cent of live births. Operative treatment was needed in a further 0.07 per cent of the recent series even though the dislocations had been diagnosed within 24 hours ofbirth. The reasons for the failure ofneonatal screening are discussed, and suggestions are made which will improve the situation. Like so many medical “discoveries”, screening tests for congenital dislocation of the hip have been described more than once. Roser (1879), Le Damanay (1912) and Putti (1 928) all emphasised the importance of neonatal diagnosis and the ease and success of treatment at this stage, with splints similar to those used today. Ortolani (1 937) described a test in which hips were examined for a visible or palpable jerk as the dislocated head slips back into the acetabulum, and Barlow (1962) sup